WHAT IS THORACIC OUTLET SYNDROME

According to the Mayo Clinic, "Thoracic outlet syndrome is a group of disorders that occur when the blood vessels or nerves in the thoracic outlet — the space between your collarbone and your first rib — become compressed. This can cause pain in your shoulders and neck and numbness in your fingers."

Sometimes an injured worker will develop this after an injury or trauma to the neck and shoulder area.  There can even be a long delay between the trauma and onset of symptoms.  Motor Vehicle Accidents and repetitive use are also potential causes for this syndrome. 

Physical therapy and treating the pain can often resolve the issue.  Your physical therapist will work with you to improve over all posture as this may help lessen numbness and pain in your arm and/or fingers. Nerve gliding is a necessary exercise that can be painful to perform, but benefits you in the long run as it loosens the nerve and may eventually relieve the compression. 

If physical therapy does not relieve the symptoms surgery may be recommended.  However, the surgery is considered risky and should be carefully discussed and considered. 

If you have been diagnosed with this syndrome or plan to seek care because you think you may have it, be prepared by having a list of questions to ask your doctor.  The Mayo Clinic provides a comprehensive list.  Not all will apply to you, but refer to it and decide which are important for you to discuss with your doctor. 

There are actually several types of Thoracic Outlet Syndrome, depending upon involvement of nerves, veins and arteries, or and undetermined involvement.  For this reason it can be difficult to diagnose and several tests may be necessary to determine what is causing your symptoms.  

After a physical examination, your doctor may send you to one or more specialists. You may have to undergo tests including vascular scans, MRI (magnetic resonance imaging), MRA (MRI with contrast), ENG (nerve conduction velocity). 

Your doctor or the specialist may do some physical tests which require you to move in specific ways meant to reproduce the pain symptoms. While painful, this can give the doctor more information on what may be causing your symptoms and aid in developing a treatment plan for you. 

If you have Thoracic Outlet Syndrome, you will need to do a few things to keep the symptoms at bay, even after physical therapy.  It is important to:

1. Maintain good posture to reduce the compression on nerves, veins and arteries
2. Take regular breaks when working
3. Practice relaxation techniques to keep your muscles from impinging the outlet

This Syndrome can be painful and frustrating, both to live with and to diagnose and treat.  If you are having symptoms don't delay talking to your doctor about them and be persistent.  If you need to, consider changing doctors or getting a second opinion. 

Be your own medical advocate, educate yourself, and ask plenty of questions!